Older Patients Could Be Overtreated With Diabetes Medications

Aggressive diabetes treatment may be unhelpful in adults over 75 years old.

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Could you be receiving too much medication for blood sugar control? Research published in the Journal of General Internal Medicine by Michael L. Maciejewski, Ph.D., and co-authors, found that older patients and Medicare recipients are frequently overtreated for their condition.

What is the Study?

Maciejewski and his fellow researchers pulled data from the Medicare records of 10 US states and focused on information from 78,792 patients. Collected from 2010 and 2011, the data focuses on adults who had a diabetes diagnosis, at least one HbA1c lab result on file and were over the age of 65 when the test was taken, and who were alive as of December 31, 2011.

They looked at the HbA1c lab results and whether they had filled any prescriptions for medications other than metformin during the months leading up to the lab test. They established a baseline for potential overtreatment of a lab result being less than 6.5% and potential undertreatment for an HbA1c lab result being more than 9.0%.

The Results of the Study?

The researchers found that about 11% of older patients were overtreated for diabetes, that’s about 8,560 people. They also noted that those most likely to be overtreated were Medicaid recipients over the age of 75 years old. This could potentially expose them to hazardous symptoms, such as dizziness and confusion. The study also found that those who were the least likely to be overtreated were Hispanics.

 

What is the Issue?

Overtreatment for diabetes is a problem because it can lead to hypoglycemia and other complications. This is also an issue for those most likely to be overtreated, adults over 75 years old, as the benefits of aggressive treatment decline in older adults. It’s important to balance the need for tightly controlled blood sugar levels with the potential short- and long-term effects.

On a final note, the study authors did note that the American Geriatrics Society started recommending less treatment for older patients in 2013. So, present day data may not reflect the same numbers of overtreatment that the data they analyzed does.

References

11% of Older Diabetes Patients Dangerously Overtreated. URL Link. Accessed September 16, 2017.

Overtreatment and Deintensification of Diabetic Therapy among Medicare Beneficiaries. URL Link. Accessed September 16, 2017.

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